OPINION: Red tape threatens access to mental health services for the most vulnerable
Like many psychologists and mental health professionals, my ability to provide patients with quality mental health care has been increasingly undermined by insurance companies demanding that I hurdle a mountain of red tape just to file a reimbursement claim. If insurers continue to hold down reimbursement rates, while demanding burdensome and time-consuming paperwork, more providers will refuse insurance payments and fewer low-income patients will have access to life-saving mental health treatment.
Insurance company red tape creates time-management issues, especially for mental health providers trying to see patients and simultaneously learn diagnostic codes and navigate inconsistent reimbursement forms. Even determining where and how to submit a claim can be challenging. Send the claim to the wrong department, the company rejects it. Submit a paper claim to a company that only accepts electronic claims, the company ignores it. Submit a claim to an insurance company that has outsourced its behavioral health services, the company returns it.
Even after mental health providers have compiled the correct information and submitted it in the proper way, we are rewarded with reimbursement rates that have been falling relative to inflation for nearly two decades. Most insurance companies tie their reimbursement rates to the rate Medicare reimburses for mental health services, which have not been raised in 18 years. Medicare today pays about 30 percent less per psychotherapy session than it did in 2001, after accounting for inflation. Since reimbursement rates from private insurers are based on the Medicare rate, they are kept lower than they would otherwise be and lower than the rates for other health care services.